| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2030 |
Assisted living, waiver; per month |
4,260 |
3,892 |
$4.08M |
| T2031 |
Assisted living; waiver, per diem |
1,148 |
930 |
$1.54M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
4,006 |
3,078 |
$334K |
| E1392 |
Portable oxygen concentrator, rental |
2,056 |
1,589 |
$168K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,410 |
1,292 |
$99K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
6,989 |
5,454 |
$85K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,583 |
1,302 |
$84K |
| 11719 |
|
2,809 |
1,313 |
$67K |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
368 |
76 |
$50K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
250 |
170 |
$31K |
| A0428 |
Ambulance service, basic life support, non-emergency transport, (bls) |
304 |
236 |
$27K |
| G0156 |
Services of home health/hospice aide in home health or hospice settings, each 15 minutes |
446 |
57 |
$27K |
| A0425 |
Ground mileage, per statute mile |
1,355 |
1,037 |
$27K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
142 |
108 |
$23K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
550 |
432 |
$16K |
| T2033 |
Residential care, not otherwise specified (nos), waiver; per diem |
13 |
13 |
$15K |
| 84443 |
Thyroid stimulating hormone (TSH) |
836 |
829 |
$11K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
445 |
442 |
$9K |
| A0433 |
Advanced life support, level 2 (als 2) |
13 |
12 |
$9K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
328 |
186 |
$9K |
| 80053 |
Comprehensive metabolic panel |
1,039 |
1,001 |
$8K |
| G0155 |
Services of clinical social worker in home health or hospice settings, each 15 minutes |
73 |
41 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
901 |
896 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
445 |
392 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
775 |
744 |
$5K |
| 80061 |
Lipid panel |
448 |
444 |
$5K |
| 99215 |
Prolong outpt/office vis |
28 |
13 |
$4K |
| 99306 |
Prolong nursin fac eval 15m |
17 |
17 |
$3K |
| K0001 |
Standard wheelchair |
824 |
621 |
$3K |
| 82607 |
|
399 |
396 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
167 |
166 |
$2K |
| 17250 |
|
30 |
12 |
$2K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
345 |
329 |
$2K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
31 |
12 |
$2K |
| 84439 |
|
195 |
193 |
$2K |
| E0570 |
Nebulizer, with compressor |
147 |
141 |
$2K |
| V5299 |
Hearing service, miscellaneous |
54 |
53 |
$2K |
| 11720 |
|
34 |
30 |
$1K |
| E1353 |
Regulator |
268 |
163 |
$1K |
| 82746 |
|
238 |
236 |
$1K |
| 85027 |
|
398 |
390 |
$555.10 |
| K0045 |
Footrest, complete assembly, replacement only, each |
486 |
292 |
$450.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
84 |
81 |
$383.04 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
62 |
61 |
$365.93 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
19 |
15 |
$256.97 |
| 82570 |
|
52 |
50 |
$209.22 |
| 83735 |
|
185 |
183 |
$205.00 |
| 81001 |
|
62 |
62 |
$190.12 |
| 82043 |
|
25 |
25 |
$177.00 |
| 92015 |
Determination of refractive state |
15 |
15 |
$150.00 |
| A4615 |
Cannula, nasal |
15 |
12 |
$120.00 |
| G0471 |
Collection of venous blood by venipuncture or urine sample by catheterization from an individual in a skilled nursing facility (snf) or by a laboratory on behalf of a home health agency (hha) |
17 |
14 |
$85.00 |
| 86480 |
|
13 |
13 |
$0.00 |
| 98960 |
|
28 |
12 |
$0.00 |
| 83970 |
|
12 |
12 |
$0.00 |
| 97163 |
|
48 |
16 |
$0.00 |
| A7031 |
Face mask interface, replacement for full face mask, each |
17 |
14 |
$0.00 |
| A7035 |
Headgear used with positive airway pressure device |
21 |
19 |
$0.00 |
| 97167 |
|
59 |
16 |
$0.00 |
| E0184 |
Dry pressure mattress |
39 |
25 |
$0.00 |
| 77080 |
|
15 |
12 |
$0.00 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
21 |
20 |
$0.00 |
| 82652 |
|
31 |
31 |
$0.00 |
| 83540 |
|
14 |
14 |
$0.00 |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
13 |
$0.00 |
| S5102 |
Day care services, adult; per diem |
114 |
24 |
$0.00 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
190 |
90 |
$0.00 |
| E0277 |
Powered pressure-reducing air mattress |
28 |
24 |
$0.00 |
| 83550 |
|
14 |
14 |
$0.00 |
| 82728 |
|
14 |
14 |
$0.00 |